Transient Global Amnesia and its treatment

Posted by kyoto @kyoto, Feb 12, 2019

Hello,
As I have written elsewhere on this site, I was treated surgically for a large, subarachnoid cyst (in the velum interpositum) in the summer of 2017. I had been experiencing severe amnesia. The operation was successful in that my memory improved. The surgeon warned of the risk of "convulsions" in the surgical plan, and over the following year or more, I had ongoing occurrences of memory loss. Last December, my surgeon started me on epilepsy medication, as a treatment for these memory failures. From my reading, I took it that I had Transient Epileptic Amnesia. Today, I went for my latest check-up and to get my next prescription of epilepsy (Vimpat aka Lacosamide), and he told me that in fact I have Transient Global Amnesia. (TGA)
So far so good, but I immediately checked the medical literature on TGA, and the first paper I read (published in QJM) says that TGA doesn't respond to anti-epilepsy drugs. https://academic.oup.com/qjmed/article/107/11/915/1512956
I thought Lacosamide is an anti-epilepsy drug. If TGA doesn't respond to it, why has the doc prescribed it? Vimpat is a non-generic drug and it's really expensive.
Does anyone have a similar situation or knowledge about TGA or its treatment?
Many thanks,
David

Interested in more discussions like this? Go to the Brain & Nervous System group.

@amandajro

@dookster I am sorry. That must be incredibly frustrating for her. Is this the first time she doesn't remember something after her memory returned?

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Think it may have happened when she had the last one3-4 years ago.She's 79. Thanks for your quick replies.

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@dookster

Think it may have happened when she had the last one3-4 years ago.She's 79. Thanks for your quick replies.

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@dookster you're most welcome. Have you notified her doctor of this latest episode?

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@amandajro

@dookster you're most welcome. Have you notified her doctor of this latest episode?

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Have an appointment to seee him next week ,including a physical. Thanks

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@kyoto, welcome back.
I noticed that you posted elsewhere (https://connect.mayoclinic.org/comment/738694/) that your diagnosis has been adjusted from transient global amnesia (TGA) to transient epileptic amnesia (TEA). I had to look these up to see that there is a difference and how they are treated is different.

See this article and excerpt.
– Transient amnesia: epileptic or global? A differential diagnosis with significant implications for management https://academic.oup.com/qjmed/article/107/11/915/1512956

"TGA is a syndrome of abrupt and temporary (<24 h) disruption of anterograde memory"
"TEA is a form of epilepsy … Compared to TGA, episodes of TEA are typically briefer (<1 h), commonly occur on waking, have a high recurrence rate and may be accompanied by other features suggestive of epilepsy such as automatisms or olfactory hallucinations."

@dookster and @pam51, may also be interested in this discussion.

Kyoto, such a relief that you don't have Alzheimer's and that you know what you're dealing with now. How is your TEA being treated?

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@colleenyoung

@kyoto, welcome back.
I noticed that you posted elsewhere (https://connect.mayoclinic.org/comment/738694/) that your diagnosis has been adjusted from transient global amnesia (TGA) to transient epileptic amnesia (TEA). I had to look these up to see that there is a difference and how they are treated is different.

See this article and excerpt.
– Transient amnesia: epileptic or global? A differential diagnosis with significant implications for management https://academic.oup.com/qjmed/article/107/11/915/1512956

"TGA is a syndrome of abrupt and temporary (<24 h) disruption of anterograde memory"
"TEA is a form of epilepsy … Compared to TGA, episodes of TEA are typically briefer (<1 h), commonly occur on waking, have a high recurrence rate and may be accompanied by other features suggestive of epilepsy such as automatisms or olfactory hallucinations."

@dookster and @pam51, may also be interested in this discussion.

Kyoto, such a relief that you don't have Alzheimer's and that you know what you're dealing with now. How is your TEA being treated?

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Dear Colleen and everyone,

This site is so interactive. I was glad to receive your answer so quickly.
Thank you for sending the link. It's really helpful.
For the TEA, I get prescribed Vimpat and Fycompa. I got started out on Vimpat (one after getting up and before bedtime) but alone this didn't suppress the symptoms, so this was Fycompa was added (two before bedtime).
My situation is way better than before but still not perfect. Also, as more time goes by, I increasingly notice that my recall of many years ago with friends and so on is much worse than my friends of that time. I figure this must be because the TEA was already present in my 30s, but I had no idea I had such a condition, and of course TEA fits are almost completely unconscious.
I am now trying to come up with ways to be more mindful in my life to avoid forgetting important information. But the loss of memories is random, and I can't keep a note of everything in my diary.
I would really like to hear about the experiences, and strategies to cope with TEA, of other people.
David

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